brain death

Summary

Summary: A state of prolonged irreversible cessation of all brain activity, including lower brain stem function with the complete absence of voluntary movements, responses to stimuli, brain stem reflexes, and spontaneous respirations. Reversible conditions which mimic this clinical state (e.g., sedative overdose, hypothermia, etc.) are excluded prior to making the determination of brain death. (From Adams et al., Principles of Neurology, 6th ed, pp348-9)

Top Publications

  1. Wu C, Chan J, Chan S, Chang A. A double-edged sword role for ubiquitin-proteasome system in brain stem cardiovascular regulation during experimental brain death. PLoS ONE. 2011;6:e27404 pubmed publisher
    Brain stem cardiovascular regulatory dysfunction during brain death is underpinned by an upregulation of nitric oxide synthase II (NOS II) in rostral ventrolateral medulla (RVLM), the origin of a life-and-death signal detected from blood ..
  2. Rodríguez Arias D, Smith M, Lazar N. Donation after circulatory death: burying the dead donor rule. Am J Bioeth. 2011;11:36-43 pubmed publisher
  3. Selcuk H, Albayram S, Tureci E, Hasiloglu Z, Kizilkilic O, Cagil E, et al. Diffusion-weighted imaging findings in brain death. Neuroradiology. 2012;54:547-54 pubmed publisher
    The purpose of the present study was to determine the role of diffusion-weighted imaging (DWI) and to investigate the use of DWI in the diagnosis of brain death (BD).
  4. Bendorf A, Kelly P, Kerridge I, McCaughan G, Myerson B, Stewart C, et al. An international comparison of the effect of policy shifts to organ donation following cardiocirculatory death (DCD) on donation rates after brain death (DBD) and transplantation rates. PLoS ONE. 2013;8:e62010 pubmed publisher
    ..widening gap between the demand for transplantable organs and the availability of organs from donation after brain death (DBD) donors...
  5. Padela A, Basser T. Brain death: the challenges of translating medical science into Islamic bioethical discourse. Med Law. 2012;31:433-50 pubmed
    Islamic ethico-legal assessments of brain death are varied and controversial...
  6. Cicora F, Stringa P, Guerrieri D, Roberti J, Ambrosi N, Toniolo F, et al. Amelioration of renal damage by administration of anti-thymocyte globulin to potential donors in a brain death rat model. Clin Exp Immunol. 2012;169:330-7 pubmed publisher
    b>Brain death (BD), a non-immunological factor of renal injury, triggers an inflammatory process causing pathological signs of cell death in the kidney, such as necrosis and apoptosis...
  7. Uwano I, Kudo K, Sasaki M, Christensen S, Østergaard L, Ogasawara K, et al. CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms. Neuroradiology. 2012;54:467-74 pubmed publisher
    ..perfusion (CTP) and magnetic resonance perfusion (MRP) are expected to be usable for ancillary tests of brain death by detection of complete absence of cerebral perfusion; however, the detection limit of hypoperfusion has not ..
  8. Lee P, Grisez G. Total brain death: a reply to Alan Shewmon. Bioethics. 2012;26:275-84 pubmed
    D. Alan Shewmon has advanced a well-documented challenge to the widely accepted total brain death criterion for death of the human being...
  9. Welschehold S, Kerz T, Boor S, Reuland K, Thomke F, Reuland A, et al. Detection of intracranial circulatory arrest in brain death using cranial CT-angiography. Eur J Neurol. 2013;20:173-9 pubmed publisher
    ..Computed tomographic-angiography (CT-A) is becoming more accepted in detecting intracranial circulatory arrest in brain death (BD)...

More Information

Publications62

  1. Ramjug S, Hussain N, Yonan N. Prolonged time between donor brain death and organ retrieval results in an increased risk of mortality in cardiac transplant recipients. Interact Cardiovasc Thorac Surg. 2011;12:938-42 pubmed publisher
    In cardiac transplantation longer ischemic times relate to poorer outcomes. However, brain death also promotes donor organ injury...
  2. Sohn C, Lee H, Park J, Chang H, Kim E, Kim E, et al. Imaging findings of brain death on 3-tesla MRI. Korean J Radiol. 2012;13:541-9 pubmed publisher
    ..T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death.
  3. Venkateswaran R, Dronavalli V, Patchell V, Wilson I, Mascaro J, Thompson R, et al. Measurement of extravascular lung water following human brain death: implications for lung donor assessment and transplantation. Eur J Cardiothorac Surg. 2013;43:1227-32 pubmed publisher
    ..extravascular lung water could aid the assessment and guide the management of potential lung donors following brain death. We therefore sought to validate a single indicator thermodilution extravascular lung water index (EVLWI-T) ..
  4. de Groot J, Vernooij Dassen M, Hoedemaekers C, Hoitsma A, Smeets W, van Leeuwen E. Decision making by relatives about brain death organ donation: an integrative review. Transplantation. 2012;93:1196-211 pubmed publisher
    ..We explored the decision making of the relatives of potential brain-dead donors, its evaluation, and the factors influencing decision making...
  5. van Dullemen L, Bos E, Schuurs T, Kampinga H, Ploeg R, van Goor H, et al. Brain death induces renal expression of heme oxygenase-1 and heat shock protein 70. J Transl Med. 2013;11:22 pubmed publisher
    ..We studied the role of stress-inducible genes Heme Oxygenase-1 (HO-1), HSP27, HSP40, and HSP70 in the kidney following a 4 hour period of brain death.
  6. Nair Collins M. Brain death, paternalism, and the language of "death". Kennedy Inst Ethics J. 2013;23:53-104 pubmed
    ..If the paternalism is not justified, then either the language used to describe organ transplantation must change radically, or it would seem to follow that much of the transplant enterprise lacks ethical justification...
  7. Wadei H, Heckman M, Rawal B, Taner C, Farahat W, Nur L, et al. Comparison of kidney function between donation after cardiac death and donation after brain death kidney transplantation. Transplantation. 2013;96:274-81 pubmed publisher
    Kidney graft survival is comparable between donation after cardiac death (DCD) and donation after brain death (DBD) kidney transplantation. However, data concerning kidney function after DCD kidney transplantation are lacking.
  8. Damman J, Seelen M, Moers C, Daha M, Rahmel A, Leuvenink H, et al. Systemic complement activation in deceased donors is associated with acute rejection after renal transplantation in the recipient. Transplantation. 2011;92:163-9 pubmed publisher
    ..In this study, we analyzed the effect of systemic complement activation in deceased donors before transplantation of their kidneys on posttransplant outcome in the recipient...
  9. Kaminska D, Koscielska Kasprzak K, Drulis Fajdasz D, Hałoń A, Polak W, Chudoba P, et al. Kidney ischemic injury genes expressed after donor brain death are predictive for the outcome of kidney transplantation. Transplant Proc. 2011;43:2891-4 pubmed publisher
    The results of deceased donor kidney transplantation largely depend on the extent of organ injury induced by brain death and the transplantation procedure...
  10. Macdonald P, Aneman A, Bhonagiri D, Jones D, O Callaghan G, Silvester W, et al. A systematic review and meta-analysis of clinical trials of thyroid hormone administration to brain dead potential organ donors. Crit Care Med. 2012;40:1635-44 pubmed publisher
    ..To review all published clinical studies of thyroid hormone administration to brain-dead potential organ donors...
  11. Stadlbauer V, Stiegler P, Taeubl P, Sereinigg M, Puntschart A, Bradatsch A, et al. Energy status of pig donor organs after ischemia is independent of donor type. J Surg Res. 2013;180:356-67 pubmed publisher
    ..Success of transplantation has been correlated with high-energy phosphate (HEP) contents of the graft...
  12. Scott J, Gentile M, Bennett S, Couture M, MacIntyre N. Apnea testing during brain death assessment: a review of clinical practice and published literature. Respir Care. 2013;58:532-8 pubmed publisher
    The diagnosis of brain death is a complex process. Strong knowledge of neurophysiology and an understanding of brain death etiology must be used to confidently determine brain death...
  13. Westphal G, Caldeira Filho M, Fiorelli A, Vieira K, Zaclikevis V, Bartz M, et al. Guidelines for maintenance of adult patients with brain death and potential for multiple organ donations: the Task Force of the Brazilian Association of Intensive Medicine the Brazilian Association of Organs Transplantation, and the Transplantation C. Transplant Proc. 2012;44:2260-7 pubmed publisher
    ..In this scenario, the intensivist occupies a prominent position as one of the professionals that first has a chance to identify brain death and to be responsible for the maintenance of the potential deceased donor.
  14. Morrissey P, Monaco A. Donation after circulatory death: current practices, ongoing challenges, and potential improvements. Transplantation. 2014;97:258-64 pubmed publisher
    ..candidacy (ventilator-dependent individuals with nonrecoverable or irreversible neurologic injury not meeting brain death criteria), there are variations in all aspects of DCD practice...
  15. Varelas P, Rehman M, Abdelhak T, Patel A, Rai V, Barber A, et al. Single brain death examination is equivalent to dual brain death examinations. Neurocrit Care. 2011;15:547-53 pubmed publisher
    Although the new Practice Parameters for brain death support a single examination, there is paucity of data comparing its impact to dual brain death (DBD) examinations.
  16. Burkle C, Schipper A, Wijdicks E. Brain death and the courts. Neurology. 2011;76:837-41 pubmed publisher
    b>Brain death determinations have been challenged in courts, but no systematic study has been published in the medical literature. Court cases on brain death determination could provide some insights for the clinical practice of physicians...
  17. Damman J, Daha M, van Son W, Leuvenink H, Ploeg R, Seelen M. Crosstalk between complement and Toll-like receptor activation in relation to donor brain death and renal ischemia-reperfusion injury. Am J Transplant. 2011;11:660-9 pubmed publisher
    ..complement C3 can also be upregulated and activated in the kidney before transplantation as a direct result of brain death (BD) in the donor...
  18. Damman J, Hoeger S, Boneschansker L, Theruvath A, Waldherr R, Leuvenink H, et al. Targeting complement activation in brain-dead donors improves renal function after transplantation. Transpl Immunol. 2011;24:233-7 pubmed publisher
    ..b>Brain death (BD) was induced in Fisher rats by inflation of an epidurally placed balloon catheter and ventilated for 6h...
  19. van Werkhoven M, Damman J, van Dijk M, Daha M, de Jong I, Leliveld A, et al. Complement mediated renal inflammation induced by donor brain death: role of renal C5a-C5aR interaction. Am J Transplant. 2013;13:875-882 pubmed publisher
    ..Donor brain death (BD) triggers inflammatory responses, including both systemic and local complement activation...
  20. Chan S, Chan J, Hsu K, Li F, Sun E, Chen W, et al. Amelioration of central cardiovascular regulatory dysfunction by tropomyocin receptor kinase B in a mevinphos intoxication model of brain stem death. Br J Pharmacol. 2011;164:2015-28 pubmed publisher
    ..We investigated the role of tropomyocin receptor kinase B (TrkB) and its downstream signalling pathways in the rostral ventrolateral medulla (RVLM) during experimental brain stem death...
  21. Bombardini T, Gherardi S, Arpesella G, Maccherini M, Serra W, Magnani G, et al. Favorable short-term outcome of transplanted hearts selected from marginal donors by pharmacological stress echocardiography. J Am Soc Echocardiogr. 2011;24:353-62 pubmed publisher
    ..The aim of this study was to establish the feasibility of an approach based on pharmacologic stress echocardiography as a gatekeeper for extended heart donor criteria...
  22. McKeown D, Bonser R, Kellum J. Management of the heartbeating brain-dead organ donor. Br J Anaesth. 2012;108 Suppl 1:i96-107 pubmed publisher
    ..However, brain death is often associated with marked physiological instability, which, if not managed, can lead to deterioration in ..
  23. Randhawa G. Death and organ donation: meeting the needs of multiethnic and multifaith populations. Br J Anaesth. 2012;108 Suppl 1:i88-91 pubmed publisher
    ..This should be of benefit to staff dealing closely with recently bereaved families and who will be requesting organ donation from them...
  24. Dominguez Gil B, Haase Kromwijk B, Van Leiden H, Neuberger J, Coene L, Morel P, et al. Current situation of donation after circulatory death in European countries. Transpl Int. 2011;24:676-86 pubmed publisher
    ..During 2000-2009, as DCD increased, donation after brain death (DBD) decreased about 20% in the three countries with a predominant controlled DCD activity, while DBD had ..
  25. Ranasinghe A, Bonser R. Endocrine changes in brain death and transplantation. Best Pract Res Clin Endocrinol Metab. 2011;25:799-812 pubmed publisher
    Following brain death (BD) many hormonal changes occur...
  26. Chan J, Tsai C, Wu C, Li F, Dai K, Sun E, et al. Sumoylation of hypoxia-inducible factor-1? ameliorates failure of brain stem cardiovascular regulation in experimental brain death. PLoS ONE. 2011;6:e17375 pubmed publisher
    One aspect of brain death is cardiovascular deregulation because asystole invariably occurs shortly after its diagnosis...
  27. Alsultan M. Utilization of intensive care units' beds occupied by brain-dead patients. Saudi J Kidney Dis Transpl. 2011;22:444-7 pubmed
    ..07). In conclusion, I believe a better utilization of the intensive care units' beds by other than brain-dead patients would not produce great cost savings, but may provide care for more patients with better quality of care...
  28. Sawicki M, Bohatyrewicz R, Safranow K, Walecka A, Walecki J, Rowinski O, et al. Dynamic evaluation of stasis filling phenomenon with computed tomography in diagnosis of brain death. Neuroradiology. 2013;55:1061-9 pubmed publisher
    ..problem in the development of reliable computed tomographic angiography (CTA) protocol in the diagnosis of brain death (BD). The aim of our study was to characterize stasis filling in the diagnosis of BD...
  29. Sereinigg M, Stiegler P, Puntschart A, Seifert Held T, Zmugg G, Wiederstein Grasser I, et al. Establishing a brain-death donor model in pigs. Transplant Proc. 2012;44:2185-9 pubmed publisher
    An animal model that imitates human conditions might be useful not only to monitor pathomechanisms of brain death and biochemical cascades but also to investigate novel strategies to ameliorate organ quality and functionality after ..
  30. Nakagawa T, Ashwal S, Mathur M, MYSORE M, Bruce D, Conway E, et al. Guidelines for the determination of brain death in infants and children: an update of the 1987 Task Force recommendations. Crit Care Med. 2011;39:2139-55 pubmed publisher
    To review and revise the 1987 pediatric brain death guidelines.
  31. Rieke A, Regli B, Mattle H, Brekenfeld C, Gralla J, Schroth G, et al. Computed tomography angiography (CTA) to prove circulatory arrest for the diagnosis of brain death in the context of organ transplantation. Swiss Med Wkly. 2011;141:w13261 pubmed publisher
    For the determination of brain death (BD) in potential organ donors, confirmatory tests that show cessation of cerebral circulation are used in many countries...
  32. Padela A, Arozullah A, Moosa E. Brain death in Islamic ethico-legal deliberation: challenges for applied Islamic bioethics. Bioethics. 2013;27:132-9 pubmed publisher
    ..Islamic scholars and medical experts have used the tools of Islamic law to formulate ethico-legal opinions on brain death. These assessments have varied in their determinations and remain controversial...
  33. Allen B, Buckberg G. Studies of isolated global brain ischaemia: I. Overview of irreversible brain injury and evolution of a new concept - redefining the time of brain death. Eur J Cardiothorac Surg. 2012;41:1132-7 pubmed publisher
    ..These findings may introduce innovative management approaches for sudden death, and perhaps stroke, because the brain is completely salvageable following ischaemic times thought previously to produce infarction...
  34. Bellingham J, Santhanakrishnan C, Neidlinger N, Wai P, Kim J, Niederhaus S, et al. Donation after cardiac death: a 29-year experience. Surgery. 2011;150:692-702 pubmed publisher
    ..To report the long-term outcomes of 1218 organs transplanted from donation after cardiac death (DCD) donors from January 1980 through December 2008...
  35. Welschehold S, Boor S, Reuland K, Thömke F, Kerz T, Reuland A, et al. Technical aids in the diagnosis of brain death: a comparison of SEP, AEP, EEG, TCD and CT angiography. Dtsch Arztebl Int. 2012;109:624-30 pubmed publisher
    The use of technical aids to confirm brain death is a controversial matter...
  36. Qazi F, Ewell J, Munawar A, Asrar U, Khan N. The degree of certainty in brain death: probability in clinical and Islamic legal discourse. Theor Med Bioeth. 2013;34:117-31 pubmed publisher
    ..Conference on Islamic Bioethics and End-of-Life Care" in April 2011 addressed the issue of brain death as the prototype for a discourse that would reflect the emergence of Islamic bioethics as a formal field of ..
  37. de Vries D, Lindeman J, Ringers J, Reinders M, Rabelink T, Schaapherder A. Donor brain death predisposes human kidney grafts to a proinflammatory reaction after transplantation. Am J Transplant. 2011;11:1064-70 pubmed publisher
    Donor brain death has profound effects on post-transplantation graft function and survival. We hypothesized that changes initiated in the donor influence the graft's response to ischemia and reperfusion...
  38. Sullivan R, Hodgman M, Kao L, Tormoehlen L. Baclofen overdose mimicking brain death. Clin Toxicol (Phila). 2012;50:141-4 pubmed publisher
    b>Brain death guidelines should be used with caution in patients with drug intoxication. It is often suggested that physicians use five half-lives of a drug when observing a patient with an overdose...
  39. Kompanje E, de Groot Y, Bakker J. Is organ donation from brain dead donors reaching an inescapable and desirable nadir?. Transplantation. 2011;91:1177-80 pubmed publisher
    The brain dead patient is the ideal multiorgan donor. Conversely, brain death (BD) is an undesirable outcome of critical care medicine. Conditions that can lead to the state of BD are limited...
  40. Luchtmann M, Bernarding J, Beuing O, Kohl J, Bondar I, Skalej M, et al. Controversies of diffusion weighted imaging in the diagnosis of brain death. J Neuroimaging. 2013;23:463-8 pubmed publisher
    Imaging techniques as confirmatory tests may add safety to the diagnosis of brain death, but are partly not accepted either because they are too invasive, such as conventional arterial angiography, or because there is still lack of ..
  41. Rady M, Verheijde J. Brain-dead patients are not cadavers: the need to revise the definition of death in Muslim communities. HEC Forum. 2013;25:25-45 pubmed publisher
    ..determining death for retrieval of transplantable organs can lead to diagnostic errors, (2) the equivalence of brain death with human death may be incorrect, and (3) end-of-life religious values and traditional rituals may be ..
  42. Webb A, Samuels O. Reversible brain death after cardiopulmonary arrest and induced hypothermia. Crit Care Med. 2011;39:1538-42 pubmed publisher
    To describe a patient with transient reversal of findings of brain death after cardiopulmonary arrest and attempted therapeutic hypothermia.
  43. Bagheri A, Tanaka T, Takahashi H, Shoji S. Brain death and organ transplantation: knowledge, attitudes, and practice among Japanese students. Eubios J Asian Int Bioeth. 2003;13:3-5 pubmed
    To investigate the knowledge, attitudes and practice of Japanese students regarding brain death and organ transplantation.
  44. Ogliari A, Caldara R, Socci C, Sordi V, Cagni N, Moretti M, et al. High levels of donor CCL2/MCP-1 predict graft-related complications and poor graft survival after kidney-pancreas transplantation. Am J Transplant. 2008;8:1303-11 pubmed publisher
    ..Using simultaneous kidney-pancreas transplantation (SPK) as a model, we showed that brain death significantly increases circulating CCL2 levels in humans...
  45. Applbaum A, Tilburt J, Collins M, Wendler D. A family's request for complementary medicine after patient brain death. JAMA. 2008;299:2188-93 pubmed publisher
    ..The present article reviews this case and discusses other cases that share key features to determine whether and when it is appropriate to accommodate requests for interventions on patients who have been declared dead...
  46. Zhou H, Liu J, Pan P, Jin D, Ding W, Li W. Carbon monoxide inhalation decreased lung injury via anti-inflammatory and anti-apoptotic effects in brain death rats. Exp Biol Med (Maywood). 2010;235:1236-43 pubmed publisher
    b>Brain death (BD) induces acute lung injury and makes donor lungs unfit for transplantation. Carbon monoxide (CO) inhalation at 50-500 ppm exerts anti-inflammatory and anti-apoptosis effects in several lung injury models...
  47. Lytle F, Afessa B, Keegan M. Progression of organ failure in patients approaching brain stem death. Am J Transplant. 2009;9:1446-50 pubmed publisher
    ..8 h (9.5-17.6). The fact that mean SOFA scores did not change significantly over time, even after BSD occurred, has implications for the timing of retrieval of organs for transplantation...
  48. Andres A, Morales E, Vazquez S, Cebrian M, Nuño E, Ortuño T, et al. Lower rate of family refusal for organ donation in non-heart-beating versus brain-dead donors. Transplant Proc. 2009;41:2304-5 pubmed publisher
    ..Cultural and religious factors as well as perception of brain death are the principal reasons for these refusals...
  49. Tibballs J. The non-compliance of clinical guidelines for organ donation with Australian statute law. J Law Med. 2008;16:335-55 pubmed
    ..Clinical guidelines for the diagnosis of whole-brain death are equated, with coma, to absence of brain-stem reflexes which essentially means the absence of spontaneous ..
  50. Joffe A, Anton N, Duff J. The apnea test: rationale, confounders, and criticism. J Child Neurol. 2010;25:1435-43 pubmed publisher
    The apnea test is recommended for the diagnosis of brain death. There are several reasons this test should be reconsidered. Confounding factors for performing the test are vaguely and poorly specified...
  51. Marthol H, Intravooth T, Bardutzky J, De Fina P, Schwab S, Hilz M. Sympathetic cardiovascular hyperactivity precedes brain death. Clin Auton Res. 2010;20:363-9 pubmed publisher
    The time preceding brain death is associated with complex dysregulation including autonomic dysfunction that may compromise organ perfusion, thus inducing final organ failure...
  52. Sperling D. Maternal brain death. Am J Law Med. 2004;30:453-500 pubmed
  53. Dictus C, Vienenkoetter B, Esmaeilzadeh M, Unterberg A, Ahmadi R. Critical care management of potential organ donors: our current standard. Clin Transplant. 2009;23 Suppl 21:2-9 pubmed publisher
    ..The pathophysiological changes following brain death entail a high incidence of complications including hemodynamic instability, endocrine and metabolic ..